Individual provider Active NPI

Charles Coonan Streit, MD

  • Urology Physician
  • Fullerton, CA
National Provider Identifier
1174522601
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A25530 Issued in CA
Practice address
301 W Bastanchury Rd
# 180
Fullerton, CA 92835-3419
Phone
(714) 870-5970
Fax
(714) 870-4792
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A25530 CA Primary

Addresses

Primary practice location

301 W Bastanchury Rd
# 180
Fullerton, CA 92835-3419

Mailing address

301 W Bastanchury Rd
# 180
Fullerton, CA 92835-3419
Phone (714) 870-5970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25530CAMDDentist
A25530CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urological Medical Group of North Orange County Urology Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1174522601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "# 180",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-870-5970",
            "fax_number": "714-870-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "# 180",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-870-5970",
            "fax_number": "714-870-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREIT",
        "first_name": "CHARLES",
        "middle_name": "COONAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A25530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.